General Election 2017 - Health & Social Care: Voters ousting Jeremy Hunt would send the Conservatives a very strong message

Health and social care in Britain is under tremendous strain and more Tory cuts won't help.

One of the biggest questions hanging over the 2017 general election is the future of funding for health services in Britain. The Conservatives have overseen one crisis after another over the last seven years.

There is a clear distinction to be made between progressives and Conservatives on how to address them. Under the Conservatives their are going to be more cuts, while the progressive parties have pledged to raise more money.

And this election even offers a symbolic way to reject the Tory approach to healthcare. Dr Louise Irvine - who previously took the government to court and won over the cutting of casualty and maternity services Lewisham Hospital closure - is standing against Health Minister Jeremy Hunt in the South West Surrey constituency.

Tactical Voting

On behalf of the National Health Action Party, Dr Irvine is standing against Jeremy Hunt and the field has been cleared. Local members of the Liberal Democrats and Labour have agreed not to campaign and the Green Party withdrew its own candidate.

The various progressive alliance movements have all offered their endorsement, including Compass - the most well known pressure group for a new more pluralism politics.

Let's be realistic: it would be a huge upset for Dr Irvine to defeat Jeremy Hunt. Last time he took 34,000 votes (with UKIP on 5,600), while Irvine took just under 5,000. However, support for the Conservatives is not innate.

Through the 1990s and into the 2000s, the Conservative-progressive split (led by the Lib Dems) averaged out at 26,000 to 26,000. Only since 2010 has Hunt opened up a significant majority. And now he's among the most well known ministers - for all the wrong reasons.

Voters in Surrey have a chance to reject Hunt's management of the NHS and the air of conflict he has created with doctors. Members and campaigners for the progressive parties have already thrown in their backing for Irvine. Now it's down to voters.

Health in Crisis

And there are a lot of reasons voters can be dissatisfied with Hunt. From strikes, to closures, to year and after year cuts to funding, Britain's healthcare system faces some dire years ahead if the Tories remain in power.

Hunt caused plenty of controversy by deciding to go toe and to toe with junior doctors over new contracts and casting them as unreasonable people taking unnecessary action. Fortunately, the public was having none of it: polls showed the public consistently behind the doctors.

The strike action over contracts goes hand in hand with discontent at the ongoing public sector pay capped, limited to a 1% rise. The policy has led to distress particularly among NHS staff, with pay not rising along with prices and the general cost of living.

Hunt's management of the NHS has also antagonised patients. One in six A&E departments across the country face closure under the Tory drive to find £22bn in cuts from the health budget in the next few years. These emergency units have been under severe strain, with waiting times targets consistently missed.

The problems with healthcare in Britain stretch beyond the Health Secretary to his party's wider approach.

One place from where extra pressure is being exerted on the NHS is social care. With no where to go, thanks to a shortage of places, hospital beds are remaining full. Elder patients are finding themselves stuck in hospitals, unable to be discharged because the social care system is at capacity.

That is in part thanks to Conservative cuts to local government funding, that has seen billions cut from social care budgets - with only token efforts to restore minimal amounts, mostly to be raised by local councils themselves, a move that is clearly punitive to poorer communities.

This failure to display compassion has overtaken welfare too. From cuts to disability benefits to attempts, appallingly, to dismiss the needs of those with mental illnesses. In an effort to cut spending on welfare, Tory policy chief George Freeman said the party wants welfare to go only to the "really disabled".

All of fronts, there appears to more concern about producing an immaculate looking balance sheet, than about the comprehensive quality service that balance sheet is supposed to be providing.

Progressive Pitch

The progressive parties are calling for a change in direction and both Labour and the Liberal Democrats have pledged more funding - and not just for the NHS itself. Both parties are calling for more to be restored to the social care system and for health and social care to be seen and treated as a joined-up service.

Labour have pledged to raise around £6 billion a year extra for the NHS, from higher taxes on the wealthy. They accompany that with investment from their proposed National Transformation Fund to upgrade hospitals and their equipment.

The Liberal Democrats go a step further. They plan to add a penny in the pound to tax, affecting all earners - but hitting the richest hardest - specifically to support the NHS and social care.

Both of these plans are a pragmatic step towards addressing the problems in the healthcare system. So would lowering stress for public sector workers by lifting the pay cap, to which both parties have committed.

Labour and the Lib Dems are also pledging to do away with some of the Conservatives more heinous welfare cuts, particularly those affecting people with disabilities.

Stand up for Healthcare

The idea of a progressive alliance is a rejection of the gerrymandering system that forces people to divide according to tribal loyalties. To bring people together who support common values and work together to ensure better representation.

In this election, the progressive alliance movement has brought parts of the Labour Party, the Liberal Democrats and the Greens together around the common values - for which they have stood in most past elections.

But standing aside for National Health Action and their candidate Dr Louise Irvine shows something more: a willingness to put aside narrow interest to fight for something larger. To put a candidate into office who has fought long and hard for the NHS.

Voters have to do two things. To vote for the candidates that stand for their values - not just for a specific party - and they need to be vocal about what is moving them. Healthcare always tops the list of people's concerns in Britain.

Jeremy Hunt has mismanaged the National Health Service. His party in government has sewn division and lacked compassion. Even if you usually vote Conservative, especially if you normally vote Conservative, rejecting Hunt and electing Dr Louise Irvine would be a strong statement.

Choosing Dr Louise Irvine would be a symbolic defence of the NHS and of the principles of compassionate universal care. But it would also put into office a tireless and independent minded local campaigner - who beat the government in the courts to stop closures and isn't afraid to call out any of the parties on their record.

Election 2015: Healthcare, public funding and the future of the NHS

One of the central issues for voters as they cast their ballot in the 2015 UK general election will be the future of the NHS. All the parties have made their pitch, each party setting out their position by juxtaposing it with the plans of their rivals. The trouble is, upon closer inspection, all of the parties are making very similar promises (Triggle, 2015).

The choice between very similar sounding options on 7th May is the product of the development of the NHS over decades. The NHS was established by the Atlee's Labour government in 1948 to be free at point of use and funded by taxation. Based on the report of the liberal William Beveridge, it represented the next step in the reform and modernisation of social welfare begun by the Liberal Party just after the turn of the century.

The free at the point of use principal was soon put to the test. With funding the service proving expensive, it was not long before charges were introduced - beginning with prescription charges. Over the years more costs have been gradually pushed away from the public purse - road accident charges to car insurers, and dental care charges, eye care charges, hospital car parking charges all to the service user.

Toward the end of her time as Prime Minister, Margaret Thatcher introduced a new 'internal market' system, where the state would not directly provide the healthcare. Instead it would procure it, on behalf of the service user, from independent hospital trusts that would have to compete to provide the service (Laurance, 2013).

Those changes initiated a direction of travel arguably continued in the Labour Party's embracing of Private Financial Initiatives (PFIs) under Blair and Brown. The benefits of the system to which Labour clung were that it opened up a short term source of funding to get hospitals built (BBC, 2002). But in the long term it has led to a huge build up of debt for hospital trusts, while allowing the private companies to profit massively (Cooper, 2014).

As for the Lib Dems, there has long been a broad party consensus on finding ways to increase choice and to ensure oversight and to devolve power (Brack et al, 2007). That made the Health and Social Care Act 2012 a complicated matter, with strong campaigning opposition to elements of the reform from within the party led by the likes of Dr Evan Harris (Harris, 2012).

Yet even with these ways of extending the means of funding the NHS and trying to find increase in service 'efficiency', the NHS is still falling short and there are fears that it will affect services (Campbell, 2015). There is little belief that Andrew Lansley's reforms have helped to ease the pressures. NHS chief executive Simon Stevens has said that the institution needs an extra £8bn a year to meet an expected £30bn shortfall by 2020 (Baker et al, 2015).

In response, all of the main parties of offered more funding, each with their own priority (Wright & Moodley, 2015).

Labour's primary position has been to distance itself from, first, the coalition's policies, and then, second, from those of New Labour. This means promising to repeal the Health and Social Care Act 2012 and introducing a cap of private profits from NHS contracts (Wintour, 2015). With NHS funding a major issue, Labour have also promised an increase of £2bn by 2016, and a £2.5bn fund for recruiting more nurses, GPs and midwives.

The Conservatives have promised to ringfence healthcare spending to protect it from cuts and to increase the budget by £2bn each year of the next parliament. However, that increase in funding is tempered by Cameron's announcement that his party would also be extending NHS services to full 24 hour coverage (Channel 4, 2015). They also later announced - to criticism of making unfunded pledges - that they would match the £8bn increase called for by the NHS (BBC, 2015).

By contrast to the other two main parties, the Liberal Democrats were initially the only party to pledge to increase NHS funding each year through to 2020 to ensure it will be, in real terms (adjusting for inflation), £8bn more than today - the amount that the NHS has stated is needed. Their main priority will the treatment of mental health, which they would put on parity with physical health and for which they would provide more funding (Perraudin, 2015).

UKIP have once again shown their chameleon-like skill at identifying the most popular mainstream policy and jumping on board - being sure to propose funding the NHS through their usual obsessions (Mason, 2015). However the personal views on the NHS of their leader Nigel Farage have been criticised by Dr John Lamport of the National Health Action Party (Lamport, 2015). He criticised Farage's praise for the Dutch and French style insurance-based system as an expensive doorway to privatisation.

However, despite their differing priorities, the similarities between the main parties and the general direction of travel towards privatisation has, for many, been a long term concern (BBC, 2003). Senior health professionals have criticised the coalition (Boseley, 2015), and others have called for whoever forms the next government to provide the funding that the NHS needs (Baker et al, 2015). These calls come with fears amongst medical professionals that after the election, charges may be introduced for basic NHS services (Campbell, 2015{2}).

Smaller third parties have taken up the fight against this perceived drift into privatisation. The National Health Action Party (NHA) represents a broadly Left-wing vision of rolling back privatisation. The NHA supports 1p rise in tax to pay for an increase of funding of £4.5m a year, phasing out prescription charges and repealing the Health and Social Care Act 2012 (BBC, 2015{2}).

However, regardless of who wins the next election, the closeness of the main parties' policies makes it likely that there will be some sort of cross-party commission to figure out the future of the NHS (Triggle, 2015). That commission will have to face the same questions that the public will at this election: do we want lower taxes or well funded public services? Because trying to have both means stretching those services ever more thinly (Toynbee, 2015).

When considering that question it's worth noting that the UK has comprehensive healthcare for which it spends far less, as a share of GDP, than most other comparable countries (Campbell & Watt, 2014). The NHS also remains an overwhelming popularly supported service (NatCen, 2015). In order to keep that service functioning, we need to understand the choices on offer about its future and to ask ourselves: when the future of the NHS is being debated, what values do we want to be represented and to underwrite its future?